Root Canal Questions - Detection and self-healing

Mar 7, 2019

I have a slightly cracked molar with large filling and looks like I'm headed toward a crown. But the possible root canal aspect raises some questions....(the dentist I've seen did not indicate a root canal but did say the need is not always simple to detect)


- If there is no obvious symptoms after a moderate toothache resolves in a few days, how is the need (or not) for a root canal determined? It would be awful to get an unnecessary root canal and also awful to get a crown done only to learn shortly down the road a root canal should have been done. Plus the possible health risks. What are methods of detection and is there some kind of preferred approach such as using a temp crown for a few months to monitor before a final crown?

- Why does most literature seem to indicate a tooth needing a root canal cannot be healed by the body? What is so different about the bacteria that can kill off the roots in a tooth but the body cannot in turn eventually kill off that bacteria and instead necessitates the need for a root canal? Or is this simply folklore propagated by the dental community in order to manage potential health-risk complications should the body be unable to fight the bacteria on it's own?

Thanks for any help in understanding these questions,



Verified Dentist
Jun 14, 2018
There are a lot of variables in determining whether a tooth needs a root canal. Sometimes it is very easy...the tooth hurts, is sensitive to percussion while adjacent teeth have no problems, shows up on x-rays with a clear infection with history of deep cavity/filling/crown, and tests negative to cold test using very cold cotton ball instead of Q-tip. Many times, it is not so clear. I did do a temp crown on a dentist colleague to determine the tooth status before a final crown a few years ago.

Natural healing of the root canal can be unpredictable. Inside the root canal, there are cells that form calcifications (secondary and tertiary dentin) to insulate and protect the nerve (nature's root canal). If the pulp dies and becomes infected, the body cannot heal the tooth because the root canal is too small for proper vascular repair. In response, the surrounding bone softens in efforts to expel the tooth...(think Tom Hanks in the movie Castaway self tooth extraction).


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